The impact of sleep on socioeconomic disparities

Humans need sleep to function well. The beneficial role of sleep in nearly all bodily functions has been studied extensively. It is well known that regularly sleeping for the recommended 7 to 9 hours greatly enhances physical health, quality of life, psychological well-being, cognitive function, and public safety. As Dr. Lauren Hale, Associate Professor of Preventive Medicine at Stony Brook Medicine, explained, “almost everything is better after a full night of sleep.”

While the benefits of sleep are well-documented, few have examined the role sleep patterns play in socioeconomic disparities. Most sleep research focused on individuals’ sleep patterns or sleep disorders in laboratory studies. Hale has analyzed large population-based datasets to examine the unfair distribution of sleep patterns and their resulting emergence and persistence of economic, social, and health disparities. Hale found that the more socially disadvantaged an individual is, in terms of race and education, the more likely an individual is to report a sleeping problem.

With regard to race, African American individuals are twice as likely to be short sleepers when compared to their Caucasian counterparts. A 2007 Chicago-based study similarly found that African American men get one hour less of sleep per night compared to Caucasian males. While one hour may not seem like a lot, one hour less of sleep, night after night, accumulates to have a substantial impact on the level at which an individual functions. Furthermore, Hale found that this sleep disparity might be a result of racism. Black individuals who felt discriminated against due to race were more likely to report sleep disturbances. There are similarly large differences in education levels that result from different sleep habits. Hale found that compared to college graduates, high school graduates are 40% more likely to be short sleepers. These disparities in race and education can set in motion a vicious cycle that further augments the disparities.

Imagine a child who grows up in a disadvantaged household with limited resources. It is likely that the parents are working multiple jobs and do not have the time to instil a regular sleeping schedule for their child. Without a routine, the child will have difficulty falling asleep, and in turn will begin going to school tired and sleep-deprived.  From a young age, the child is now disadvantaged, as the lack of regular sleep will make it more challenging for the child to grasp concepts. As the sleep deprivation continues throughout high school, this gap will widen, as the teenager will not perform as well in all aspects of school, greatly decreasing the probability that he/she will attend college. This individual will likely end up in the same situation as his/her parents and will pass down irregular sleeping patterns to the next generation.

Hale found statistical evidence of this repeating cycle in a national birth cohort study. Children who lack a bedtime routine at age three, sleep worse and for a shorter duration. “As early as in the preschool years, differences in bedtimes by race and education, set children on a trajectory for lower health, cognitive, and behavioral outcomes,” Hale explained. Intervention at a young age is the best way to alleviate these disparities, but is very difficult to implement on a large scale.

Currently, Hale is collecting data about sleep and physical activity of 1,000 adolescents, to better understand, “how sleep fits into the busy lifestyle of teenagers.” Through her new study, she aims to better characterize the implications of sleep on mental health, obesity, future lifestyle choices, and ultimately socioeconomic disparities.